In light of the recent disclosures of the U.S. government engaging in massive data collection of private information about its citizens, I am sure that many people are concerned about the security of their medical information, and whether it can be accessed by the NSA or other government surveillance organizations.
The short answer, here at the Center for Alternative Medicine, is no. The health and medical information that we have is protected from government and other unauthorized access in multiple ways, which I will describe below.
Because of the location of my practice and my somewhat unique skillset, I have long taken a security-conscious approach to my patient's records, an approach which informed the choices I made when we began digitizing patient data. In light of the news over the past couple of days, I have already made some modifications to the Center's security policies which will further protect my patients' health records.
Operating System Security
As a first step, as we began to put patient charts into digital form, I migrated all of the office's computers to the Linux operating system. Linux is a far more secure operating system than either Windows or MacOS. In fact, because of its secure nature, Linux is the operating system that is used by the vast majority of internet data servers, many of which are under daily multiple attack.
Linux security goes far beyond firewalls and passwords. Linux is designed from the ground up to be largely immune to viruses and "trojan horse" programs. Security is built-in to the system's design, preventing the rather massive security holes which Windows has always exhibited. Furthermore, since all of the software on my Linux systems is open, no secret back doors into the system can exist. They would be immediately spotted by the community which develops and maintains these systems.
Backup and Online Security
The Center's secured and encrypted local network is also protected by software which immediately informs me if unidentified devices are attempting to access it, even as that access is being denied. Furthermore, none of the computers which store patient data are accessible to any device outside of our local network.
Off-site backup is handled via encrypted VPN and the data is stored on servers outside of the U.S., in a country where data privacy laws are considerably more stringent than in the U.S. The companies operating these servers cannot be coerced by the government into releasing any information.
Email and Patient Communications
Similarly, the email server I use is located overseas in a country secure from U.S. governmental interference or access. Connection to that email server uses end-to-end data encryption, eliminating the possibility of passive data acquisition of both content and metadata.
Though I have not made a habit of it thus far, I have for years been equipped with the ability to send and receive email using PGP encryption. One of the changes I have made in the Center's policy this week is to begin providing my public secure key to patients who wish to use PGP to protect our doctor-patient communications. This provides a second level of security.
And while I have on occasion answered patient questions via Facebook messaging, it is something I have never been entirely comfortable with, and have never initiated. One of the policy changes this week is that neither I nor my staff will communicate health information or discuss health issues with patients via Facebook messaging.
How You Can Protect Your Health Information
There are several steps which you can take to protect your health information, and they are relatively simple.
The first is to drop Gmail like a rock. It is clearly insecure, and Google has been part of the PRISM data collection system for years. There are several other systems which offer free email accounts and which are secure and will not disclose your data to the government. The one I recommend is Zoho, though there are several others.
Second, use a VPN for all of your internet activities. The end-to-end encryption of a VPN prohibits anyone from from watching your passage through the internet (and, yes, disable cookies on your browser!)
Third, use an alternative search engine. The amount of data Google collects on you -- and provides to the government -- is enormous. Your interests are determined by your search habits, and this information is a gold mine for those interested in your health data. There are, however, other search engines that do not collect or store your search data. At the Center, we use DuckDuckGo, a flexible and powerful search engine which also enables you to perform anonymous Google searches. Another popular privacy-oriented search engine is ixquick.
How Secure Are These Measures?
With regard to your health data, I have taken steps to protect your data far and above most other health care providers. Nobody is immune to hacker attack, and I make no claims to that, but I have done my best to ensure that your data remains secure from more than the passive data acquisition that the government appears to be engaging in, as well as typical commercial skullduggery.
Over the summer, I will continue to test and refine our security measures. But rest assured that even at this moment, your confidential health information at the Center is as protected, if not better protected than at any much larger organization.